Deltoid Muscle

The sites for IM administration are the deltoid muscle (upper arm), the ventrogluteal or dorso-gluteal sites (hip), and the vastus lateralis (thigh Pig. 2-7). The vastus lateralis site is frequently used for infants and small children because it is more developed than the gluteal or deltoid sites, hi children who have been ambulating for more than 2 years the ventrogluteal site may be used. 

The most common adverse effects in adults include injection site reactions (e.g., tenderness, pain, and warmth), headaches within 5 days after vaccination, and fatigue. Local reactions may be minimized by using an appropriate needle length based on the person s age and size and by administering the injection intramuscularly in the deltoid muscle. Children may also have feeding disturbances. Hepatitis A vaccine given... 

DMPA 150 mg administered by deep intramuscular injection in the gluteal or deltoid muscle within 5 days of the onset of menstrual bleeding inhibits ovulation for more than 3 months, and the dose should be repeated every 12 weeks to ensure continuous contraception. A new formulation contains 104 mg of DMPA (Depo-SubQ Provera 104), which is injected subcutaneously into the thigh or abdomen. The manufacturer recommends excluding pregnancy in women more than 1 week late for repeat injection of the intramuscular formulation or 2 weeks late for repeat injection of the subcutaneous formulation. 

In the morning, I injected atropine into each subject s deltoid muscle and waited for the onset of the usual symptoms. Nothing happened for about ten minutes. Then, a loud yell came from Snooks cubicle, temporarily bolted to keep him from wandering while disoriented. 

IM 300 mg. The deltoid muscle is preferred. Avoid intravascular injection. Use only the 10% solution for IM injection. 

The LidoPen Auto-Injector un t is for self-administration into deltoid muscle or anterolateral aspect of thigh. Patient instructions are provided with product. 

Absorption/Distribution - Lidocaine is ineffective orally it is most commonly administered IV with an immediate onset (within minutes) and brief duration (10 to 20 minutes) of action following a bolus dose. Continuous IV infusion of lidocaine (1 to 4 mg/min) is necessary to maintain antiarrhythmic effects. Following IM administration, therapeutic serum levels are achieved in 5 to 15 minutes and may persist for up to 2 hours. Higher and more rapid serum levels are achieved by injection into the deltoid muscle. Therapeutic serum levels are 1.5 to 6 mcg/mL serum levels greater than 6 to 10 mcg/mL are usually toxic. Lidocaine is approximately 50% protein bound (concentration-dependent). 

The soluble substances, mild irritants and suspensions can be injected by this route in the large skeletal muscles (deltoid, triceps, gluteus maximus, rectus femoris etc.). These muscles are less richly supplied with sensory nerves and are more vascular, so irritant solutions can be injected. Small volumes (up to 2 ml) are injected into the deltoid muscle, and small or large volumes (up to 10 ml) are injected into the gluteal mass. 

Adults 1 ml by IM injection into the deltoid muscle repeated one month and six months later. 

Absorption of i.m. administered medications depends on the injection site because perfusion of individual muscle groups differs. For example, drug absorption from the deltoid muscle is faster than that from the vastus lateralis that is more rapid than from the glu-teus. In addition, lower perfusion or hemostatic decompensation, frequently observed in ill neonates and young infants, may reduce i.m. absorption. It may also be decreased in neonates who receive a skeletal muscle-paralyzing agent such as pancuronium because of decreased muscle contraction. In addition, the smaller muscle mass of neonates and young infants provides a small absorptive area. 

The deltoid muscle can be used for i.m. injections in older children, but it is not an option for young infants and children because of their limited muscle mass. Although there are few complications associated with this administration route, nerve injury can occur. The technique is shown in Fig. The area for deltoid administration should be fully visible so that the anatomical landmarks can be visualized. Then the needle for deltoid injection should enter the muscle halfway between the acromium process and the deltoid tuberosity to avoid hitting the underlying nerves. The drug volume that can be administered by this route to older children and adults is 0.1-2ml.The recommended needle length for older children is 1 in. (2.5 cm). 

Route of Administration Intravenously is nearly instantaneously absorbed. Intramuscular has slower absorption depending on the amount of blood vessels at the injection site. Subcutaneous tissue injection sites have a slower absorption rate than muscles. (Hint Medication is absorbed faster in the deltoid [arm] muscle than the gluteal [backside] muscle because there are more blood vessels in the deltoid muscle.)... 

IM Use 10% (100 mg/ml) clearly identify lidocaine that is for IM use give in deltoid muscle (blood level is significantly higher than if injection is given in gluteus muscle or lateral thigh) Instruct patient that local infiltration may bum and sting briefly... 

For children older than 18 months of age Use of the deltoid muscle for IM injections is associated with less pain than injections administered in the thigh. For children older than 3 years of age Use of the ventrogluteal area for injection is associated with less pain than the anterior thigh or dorsogluteal area. 

Swelting at the elbow is most evident at the radiohumeral joint. Shonlder pain may resnlt from involvement of the joint itself or from tendon inflammation (tendinitis) or inflammation of the bursa (bursitis) near the deltoid muscle. 

Intramuscular vaccine should be given in the deltoid muscle in adults and in the anterolateral thigh in children. The gluteal region should not be used. The lateral aspect of the deltoid should be used for intradermal injection of HDCV when used for preexposure prophylaxis... 

The rate at which dmg particles are absorbed is determined by the amount of blood vessels there are in the area where the dmg is administered. Dmg particles are nearly instantaneously absorbed if the dmg is injected intravenously (IV). A slower absorption rate occurs if the dmg is administered intramuscularly (IM). The IM rate is dependent on the amount of blood vessels there are at the site of the injection. For example, a dmg is absorbed faster in the deltoid (arm) muscle than in the gluteal (butt) muscle because there are more blood vessels in the deltoid muscle. Dmgs injected in subcutaneous (SC) tissue are absorbed slower than those injected via IM injections because there are fewer blood vessels in subcutaneous tissues than in muscles. 

This vaccine is administered intramuscularly into the deltoid muscle. 

The primary nurse is at the bedside and is preparing to administer 3 mL of medication into the deltoid muscle. Which action should the charge nurse take ... 

This is the correct action to take because the charge nurse should not correct the primary nurse in front of the client. The deltoid muscle (in the upper arm) should not be used to administer 3 mL of medication intramuscularly because the muscle is small and can only accommodate small doses of medications, no more than 1-2 mL of medication. 

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